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  • Writer's pictureGrace Health

Why Am I Bleeding After Sex?

Updated: May 15

Imagine you just had sex with your partner and when you look down you notice blood on the sheets. Perhaps you noticed when you went to do the routine ‘pee after sex’ and when you wiped you noticed blood. You know for sure you are not on your period or even expecting it soon and it certainly is not your first time having sex. So then, why are you bleeding? Let’s find out.


Probable reasons
  1. Vaginal tearing

  2. Vaginal dryness

  3. Infections

  4. Cervical ectropion

  5. Cervical or endometrial polyps or fibroids

  6. Endometriosis

  7. Cancers






Is it normal to bleed after sex?

As scary as it may seem it is not uncommon to bleed after intercourse. Many women experience vaginal bleeding after sex at one time or another. Referred to as postcoital bleeding and affects up to 9% of menstruating women. Usually, there’s probably no cause for concern but it can happen for many reasons. In some cases, it could also indicate underlying health conditions.


What causes the bleeding?

The most common causes for vaginal bleeding after sex both start in the cervix, which is the narrow, tube-like end of your uterus that opens into the vagina. Especially younger people who haven’t reached menopause.


Some of the most common causes of bleeding after sex include:


Vaginal tearing

Vigorous sex can cause small cuts or scrapes to the vagina. This is more likely to happen if you have vaginal dryness due to menopause, breastfeeding, or other factors.


Vaginal dryness

When the skin is dry it becomes extremely vulnerable to damage. Common causes of vaginal dryness include:

  • having intercourse before being fully aroused

  • friction during intercourse

  • douching

  • chemicals in feminine hygiene products, laundry detergents, and pools

  • breastfeeding

  • childbirth

  • certain medications, including cold medication, asthma medications, some antidepressants, and anti-estrogen drugs

  • having your ovaries removed

  • chemotherapy and radiation therapy

  • Sjögren’s syndrome is an inflammatory disease of the immune system that reduces moisture generated by glands in the body

Infections

Any type of infection can cause inflammation of vaginal tissues, making them more vulnerable to damage. These commonly include:

  • sexually transmitted infection (STI), such as chlamydia

  • pelvic inflammatory disease (PID), is an infection of the reproductive organs in the lower abdomen, which includes the fallopian tubes, ovaries, cervix, and uterus

  • cervicitis, which is inflammation of the cervix that occurs as the result of an infection

  • vulvovaginitis, which is inflammation of the vulva and vagina that often occurs due to an infection

Cervical ectropion

It is considered benign or not harmful. It occurs when the cell type that typically grows on the inside of the cervix grows on the outside instead. Cervical ectropion may result in an inflamed area. This condition usually clears up without treatment, but it can cause spotting and vaginal bleeding.


Cervical or endometrial polyps or fibroids

Polyps and fibroids are tiny noncancerous growths. They commonly grow on the lining of the cervix or uterus, especially in menstruating people, and can cause pain and bleeding.


Endometriosis

Endometriosis causes endometrial tissues, the tissues that line the uterus, to grow outside of the uterus. This can cause inflammation, usually in the pelvic region and lower abdomen.


Cancers

Cancers that impact the reproductive system or urogenital tract can alter vaginal tissues and hormone levels, making them more vulnerable to damage. Irregular vaginal bleeding, including bleeding after sex, is a common symptom of cervical or vaginal cancer.


What would put me at greater risk of bleeding?

You may be at greater risk of postcoital bleeding if you:

  • aren’t fully aroused before intercourse

  • douche frequently

  • have cervical or uterine cancer

  • recently had a baby or are breastfeeding

  • are in perimenopause, menopause, or are postmenopausal


When should I see a doctor?

The symptoms you may experience along with postcoital bleeding vary depending on the cause. Speak with a doctor if postcoital bleeding is accompanied by symptoms like:

  • vaginal burning or itching

  • abnormal discharge

  • intense abdominal pain

  • nausea, vomiting, or lack of appetite

  • stinging or burning when urinating or during intercourse

  • lower back pain

  • unexplained fatigue and weakness

  • headaches or lightheadedness

  • abnormally pale skin

  • bladder or bowel symptoms


What treatment options do I have?

The cause of your vaginal bleeding will determine your treatment. Potential treatment options include:

  • vaginal moisturizers, available for purchase online.

  • antibiotics for infections caused by bacteria, such as gonorrhoea, syphilis, and chlamydia

  • medications for viral infections

  • surgical removal, cryotherapy, or electrocautery in cases of cervical ectropion

  • removal of polyps, especially those that cause significant bleeding or appear abnormal

  • surgery or therapy for cancer

  • low-dose vaginal estrogen therapy, in the form of creams, suppositories, or rings, for vaginal dryness


Is there anything I can do to prevent it?

Unfortunately minor postcoital bleeding can often not be prevented. However, the following actions tend to greatly reduce the severity and frequency of bleeding. Here are some prevention tips:

  • staying hydrated

  • avoiding aggressive sexual acts

  • using water- or silicon-based lubricants during foreplay and intercourse. A range of lubricants are available for purchase online.

  • avoiding scented or flavoured feminine products

  • always using condoms, especially when engaging with different sexual partners

  • talking with sexual partners about anxieties and reluctance surrounding intercourse

  • trying to become aroused before engaging in intercourse

  • seeking medical advice and treatment for suspected infections


The bottom line

Bleeding after sexual intercourse is common, especially in people who are no longer menstruating or who have ovarian conditions. It can be caused by dryness, infections, or other conditions such as cervical or uterine cancer. If the bleeding is occasional and mild, you may not need to see a doctor. But if the bleeding occurs often, occurs alongside other symptoms, or you have postcoital bleeding after menopause, it may be best to see a doctor.

Stay informed, stay in control Hope this helps



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